Provider Demographics
NPI:1326103409
Name:EVELYN L RODRIGUEZ
Entity Type:Organization
Organization Name:EVELYN L RODRIGUEZ
Other - Org Name:FARMACIA DEL CARMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-839-1769
Mailing Address - Street 1:75 CALLE MORSE
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-2618
Mailing Address - Country:US
Mailing Address - Phone:787-839-1769
Mailing Address - Fax:787-271-3691
Practice Address - Street 1:75 CALLE MORSE
Practice Address - Street 2:
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714-2618
Practice Address - Country:US
Practice Address - Phone:787-839-1769
Practice Address - Fax:787-271-3691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR07F13733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy